Orthopaedic implants including peripheral aperture arrangements

ABSTRACT

This disclosure relates to orthopaedic implants and methods for repairing bone defects and restoring functionality to a joint. The implants disclosed herein include augment geometries that may approximate a surface contour or bone void along a surgical site and include patterns of peripheral apertures that may be utilized for improved fixation of the implants at the surgical site.

BACKGROUND

This disclosure relates to orthopaedic procedures and, moreparticularly, to orthopaedic implants and methods for repairing bonedefects and restoring functionality to a joint.

Many bones of the human musculoskeletal system include articularsurfaces. The articular surfaces articulate relative to other bones tofacilitate different types and degrees of joint movement. The articularsurfaces can erode or experience bone loss over time due to repeated useor wear or can fracture as a result of a traumatic impact. These typesof bone defects can cause joint instability and pain.

Bone deficiencies may occur along the articular surfaces of the glenoidbone. Some techniques utilize a bone graft and/or implant to fill adefect in the glenoid bone. The implant may be secured to the glenoidutilizing one or more fasteners.

SUMMARY

This disclosure relates to orthopaedic implants and methods. Theimplants may be used during methods for repairing bone defects. Theimplants described herein may be utilized to restore functionality to ajoint and include peripheral apertures arranged in one or more patternsfor receiving fasteners to secure the implants at a surgical site.

An orthopaedic implant may include a baseplate including a plate bodyextending along a longitudinal axis between a front face and a rear faceand may include an anchoring stem extending outwardly from the rearface. The plate body may include a main body portion establishing thefront face, an augment portion extending outwardly from the main bodyportion to establish an augment face section of the rear face, and aplurality of peripheral apertures circumferentially distributed aboutthe longitudinal axis. A perimeter of the plate body may besubstantially circular. The peripheral apertures may be dimensioned toreceive respective fasteners for securing the baseplate to a surgicalsite. The augment face section may be arranged transversely relative tothe longitudinal axis, and first and second reference planes arrangedperpendicular to each other extend along the longitudinal axis such thatthe first reference plane may bisect the augment face section. Allperipheral apertures of the baseplate that are arranged about thelongitudinal axis may be circumferentially offset from both of the firstand second reference planes.

A kit for arthroplasty may include a set of baseplates and a pluralityof fasteners. Each baseplate of the set of baseplates may include aplate body having a main body portion and a substantially wedge-shapedaugment portion that cooperate to establish a front face and a rear faceof the plate body, and a plurality of peripheral apertures extendingbetween the front and rear faces. The peripheral apertures may bedimensioned to receive respective ones of the fasteners to secure theplate body to a surgical site. A first reference plane may extend alonga longitudinal axis of the plate body to bisect the augment portion. Theset of baseplates may include a first baseplate and a second baseplate,the peripheral apertures of the first baseplate may be circumferentiallydistributed about the longitudinal axis to establish a first patternsuch that one or more of the peripheral apertures extend along the firstreference plane, and the peripheral apertures of the second baseplatemay be circumferentially distributed about the longitudinal axis toestablish a second pattern, the second pattern may be circumferentiallyoffset from the first pattern relative to the longitudinal axis, and thefirst and second patterns may have a common circumferential spacingbetween the respective peripheral apertures.

A method of installing an orthopaedic implant at a surgical site mayinclude selecting a baseplate from a set of baseplates based on asurface profile of a surgical site. Each baseplate of the set ofbaseplates may include a plate body having a main body portion and asubstantially wedge-shaped augment portion that cooperate to establish afront face and a rear face of the plate body, and a plurality ofperipheral apertures may extend between the front and rear faces. Afirst reference plane may extend along the longitudinal axis to bisectthe augment portion. The set of baseplates may include a first baseplateand a second baseplate, the peripheral apertures of the first baseplatemay be arranged to establish a first pattern such that one or more ofthe peripheral apertures extend along the first reference plane, and theperipheral apertures of the second baseplate may be arranged toestablish a second pattern circumferentially offset from the firstpattern relative to the longitudinal axis, and the first and secondpatterns may have a common circumferential spacing between therespective peripheral apertures. The method may include positioning theselected baseplate relative to the surface profile of the surgical siteand may include positioning a fastener in a respective one of theperipheral apertures to secure the selected baseplate to the surgicalsite.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 illustrates a side view of an exemplary orthopaedic implantincluding a baseplate and glenosphere.

FIG. 2 illustrates a perspective view of the implant of FIG. 1 with theglenosphere in an uninstalled position.

FIG. 3 illustrates a plan view of the baseplate of FIG. 2 including anexemplary pattern or layout of peripheral apertures.

FIG. 4 illustrates a perspective view of the baseplate of FIG. 2.

FIG. 5 illustrates a sectional view of the implant of FIG. 1.

FIG. 6 illustrates a sectional view of the baseplate of FIG. 2.

FIG. 7 illustrates an exemplary pattern or layout of peripheralapertures.

FIG. 8 illustrates a perspective view of a baseplate.

FIG. 9 illustrates a plan view of the baseplate of FIG. 8 including anexemplary pattern or layout of peripheral apertures.

FIG. 10 illustrates a sectional view of the baseplate of FIG. 8.

FIG. 11 illustrates a perspective, sectional view of the baseplate ofFIG. 10.

FIG. 12 illustrates a perspective view of the baseplate of FIG. 8.

FIG. 13 illustrates a sectional view of the baseplate of FIG. 12.

FIGS. 14-15 illustrate exemplary patterns or layouts of peripheralapertures.

FIG. 16 illustrates a side view of an exemplary orthopaedic implantincluding a baseplate and glenosphere.

FIG. 17 illustrates a perspective view of the implant of FIG. 14 withthe glenosphere in an uninstalled position.

FIGS. 18-19 illustrate sectional views of the baseplate of FIG. 16.

FIG. 20 illustrates an exemplary patterns or layouts of peripheralapertures.

FIGS. 20A-20B illustrate exemplary baseplate profiles.

FIG. 21 illustrates an exemplary method of installing an orthopaedicimplant at a surgical site.

FIG. 22 illustrates an exemplary implant positioned at a surgical site.

FIG. 23 illustrates an exemplary implant positioned at a surgical site.

FIGS. 24A-24E illustrate the baseplate of FIG. 2 situated relative to asurgical site at different view angles.

FIGS. 25A-25E illustrate the baseplate of FIG. 8 situated relative to asurgical site at different view angles.

FIG. 26 illustrates a plan view of an exemplary orthopaedic implantincluding a baseplate having an augment portion in a first position.

FIG. 27 illustrates the baseplate of FIG. 26 including the augmentportion in a second position.

DETAILED DESCRIPTION

This disclosure relates to orthopaedic implants and methods forrepairing bone defects. The implants described herein may be utilizedduring arthroplasty procedures and incorporated into a shoulderprosthesis for restoring functionality to shoulders having advancedcartilage disease. The disclosed implants may be utilized to addresscomplex glenoid pathology, which may have bony deficiencies at manydifferent orientations relative to the Superior/Inferior (S/I) plane ofthe glenoid face. The implants can include augment geometries configuredto fill bone voids along the glenoid face. The disclosed implants mayinclude peripheral apertures arranged in patterns. The disclosedpatterns can be utilized to improve fixation of the respective implantat the surgical site, which can lead to improved healing.

An orthopaedic implant according to an exemplary aspect of the presentdisclosure may include a baseplate including a plate body extendingalong a longitudinal axis between a front face and a rear face and mayinclude an anchoring stem extending outwardly from the rear face. Theplate body may include a main body portion establishing the front faceand may include an augment portion extending outwardly from the mainbody portion to establish an augment face section of the rear face. Aplurality of peripheral apertures may be circumferentially distributedabout the longitudinal axis. The peripheral apertures may be dimensionedto receive respective fasteners for securing the baseplate to a surgicalsite. The augment face section may be arranged transversely relative tothe longitudinal axis, and first and second reference planes may bearranged perpendicular to each other extend along the longitudinal axissuch that the first reference plane bisects the augment face section,and all peripheral apertures of the baseplate that are arranged aboutthe longitudinal axis may be circumferentially offset from both of thefirst and second reference planes.

In some embodiments, a perimeter of the plate body may be substantiallycircular.

In some embodiments, the anchoring stem may extend along thelongitudinal axis.

In some embodiments, the plurality of peripheral apertures may besubstantially equally distributed about the longitudinal axis.

In some embodiments, the plurality of peripheral apertures may include atotal of four peripheral apertures.

In some embodiments, a third reference plane may extend along thelongitudinal axis such that the first and third reference planesestablish an acute angle, and a pair of the peripheral apertures may becircumferentially arranged along the third reference plane.

In some embodiments, the acute angle may be greater than 0 degrees butis less than 45 degrees.

In some embodiments, the acute angle may be between 30 degrees and 60degrees.

In some embodiments, the plurality of peripheral apertures may include atotal of four peripheral apertures.

In some embodiments, the four peripheral apertures may be substantiallyuniformly distributed about the longitudinal axis.

In some embodiments, the rear face may include a second face sectionarranged substantially perpendicular to the longitudinal axis, and theaugment face section and the second face section may be joined at aninterface to establish an obtuse angle.

In some embodiments, the obtuse angle may be between 140 degrees and 170degrees.

In some embodiments, the implant includes a glenosphere including anarticulating surface which may have a generally convex geometry, and theglenosphere may be secured to the baseplate adjacent the front face.

In some embodiments, the glenosphere may include a recess dimensioned toat least partially receive the main body portion of the baseplate.

In some embodiments, a perimeter of the main body portion of thebaseplate may be dimensioned to cooperate with a perimeter of the recessto establish a Morse taper connection.

A kit for arthroplasty according to an exemplary aspect of the presentdisclosure may include a set of baseplates and a plurality of fasteners.Each baseplate of the set of baseplates may include a plate body havinga main body portion and a substantially wedge-shaped augment portionthat may cooperate to establish a front face and a rear face of theplate body, and may include a plurality of peripheral aperturesextending between the front and rear faces. The peripheral apertures maybe dimensioned to receive respective ones of the fasteners to secure theplate body to a surgical site. A first reference plane may extend alonga longitudinal axis of the plate body to bisect the augment portion. Theset of baseplates may include a first baseplate and a second baseplate.The peripheral apertures of the first baseplate may be circumferentiallydistributed about the longitudinal axis to establish a first patternsuch that one or more of the peripheral apertures may extend along thefirst reference plane. The peripheral apertures of the second baseplatemay be circumferentially distributed about the longitudinal axis toestablish a second pattern, the second pattern may be circumferentiallyoffset from the first pattern relative to the longitudinal axis, and thefirst and second patterns may have a common circumferential spacingbetween the respective peripheral apertures.

In some embodiments, the implant may include an anchoring stem which mayextend outwardly from the rear face along the longitudinal axis. Theimplant may include glenosphere including an articulating surface whichmay have a generally convex geometry, and the glenosphere may bereleasably secured to a respective one of the baseplates adjacent thefront face.

In some embodiments, a perimeter of the main body portion may besubstantially circular, and the peripheral apertures of both the firstpattern and the second pattern may be substantially equally distributedabout the longitudinal axis.

In some embodiments, a second reference plane may extend along thelongitudinal axis and may be perpendicular to the first reference plane,and the second pattern may be established such that all peripheralapertures of the second baseplate that are arranged about thelongitudinal axis may be circumferentially offset from both of the firstand second reference planes.

A method of installing an orthopaedic implant at a surgical siteaccording to an exemplary aspect of the present disclosure may includeselecting a baseplate from a set of baseplates based on a surfaceprofile of a surgical site. Each baseplate of the set of baseplates mayinclude a plate body having a main body portion and a substantiallywedge-shaped augment portion that may cooperate to establish a frontface and a rear face of the plate body, and may include a plurality ofperipheral apertures extending between the front and rear faces. A firstreference plane may extend along the longitudinal axis to bisect theaugment portion. The set of baseplates may include a first baseplate anda second baseplate. The peripheral apertures of the first baseplate maybe arranged to establish a first pattern such that one or more of theperipheral apertures may extend along the first reference plane. Theperipheral apertures of the second baseplate may be arranged toestablish a second pattern circumferentially offset from the firstpattern relative to the longitudinal axis, and the first and secondpatterns may have a common circumferential spacing between therespective peripheral apertures. The method may include positioning theselected baseplate relative to the surface profile of the surgical siteand may include positioning a fastener in a respective one of theperipheral apertures to secure the selected baseplate to the surgicalsite.

In some embodiments, the plurality of peripheral apertures may include atotal of four peripheral apertures, a second reference plane may extendalong the longitudinal axis and may be perpendicular to the firstreference plane, two of the peripheral apertures of the first patternmay be arranged along the first reference plane, and another two of theperipheral apertures of the first pattern may be arranged along thesecond reference plane, and the second pattern may be established suchthat all peripheral apertures of the second baseplate may becircumferentially offset from both the first and second referenceplanes.

In some embodiments, an anchoring stem may extend outwardly from therear face along the longitudinal axis. The method may includepositioning the anchoring stem in a bone hole along the surgical siteand may include securing a glenosphere to the selected baseplate. Theglenosphere may include an articulating surface having a generallyconvex geometry.

FIGS. 1-6 illustrate an exemplary orthopedic implant 20. The implant 20can be utilized for various surgical procedures, such as arthroplastyprocedures to repair a joint. For example, the implant 20 can beincorporated into a shoulder prosthesis. Although the implants disclosedherein primarily refer to repair of a defect in a glenoid during ashoulder reconstruction, such as a reverse shoulder procedure, it shouldbe understood that the disclosed implants may be utilized in otherlocations of the patient and other surgical procedures.

Referring to FIGS. 1-2, the implant 20 includes a baseplate 22 and aglenosphere 24 releasably secured to the baseplate 22. The baseplate 22includes a plate body 26 extending along a longitudinal axis A (FIG. 2)between a front (or first) face 28 (FIG. 2) and a rear (or second) face30 generally opposed to the front face 28. The rear face 30 maygenerally correspond to a medial side of a patient, and the front face28 may generally correspond to a lateral side of the patient whenimplanted in a surgical site, for example.

The baseplate 22 can include a post or anchoring stem 32 extendingoutwardly from the rear face 30. A central axis of the anchoring stem 32may be offset from the longitudinal axis A. In FIG. 2, the anchoringstem 32 extends along the longitudinal axis A and has a substantiallycylindrically geometry. The anchoring stem 32 may be dimensioned forinsertion in a glenoid or bone hole which may be formed to secure thebaseplate 22, for example.

The anchoring stem 32 can include a first stem portion 34 and a secondstem portion 36. The first stem portion 34 can be integrally formed withthe plate body 26. The anchoring stem 32 and plate body 26 may beseparate and distinct components. The first stem portion 34 can bemechanically attached or otherwise secured to the second stem portion 36utilizing various techniques, such as threading, bonding and welding. InFIGS. 5-6, the first stem portion 34 and second stem portion 36 areconnected via a reversed taper connection. The anchoring stem 32 may bea single component.

Referring to FIG. 2, with continuing reference to FIG. 1, the plate body26 includes a main body portion 38 and an augment portion 40 extendingoutwardly from the main body portion 38. The main body portion 38 mayestablish a perimeter 39 of the plate body 26. The perimeter 39 of theplate body 26 can have an elliptical geometry, for example. In FIGS.3-4, the perimeter 39 of the plate body 26 has a substantially circulargeometry. A substantially circular geometry may reduce a reaming widthand complexity of preparing a surgical site to accept the implant 20.The main body portion 38 establishes a front face 28 of the plate body26. The augment portion 40 establishes at least a portion of the rearface 30.

Various materials can be utilized to form the baseplate 22 andglenosphere 24. The baseplate 22 and glenosphere 24 may be made ofmetallic materials. The implant 20 can include one or more coatings orlayers 41 deposited along surfaces of the baseplate 22. Example coatings41 can include calcium phosphate (CaP) having a porous construction forpromoting bone growth.

The augment portion 40 can be dimensioned to approximate various defectgeometries and surface contours that may be encountered along a surgicalsite. The augment portion 40 may be configured to at least partiallyfill a bone void in a glenoid. The augment portion 40 can be dimensionedto establish a relative lesser or greater overall volume of thebaseplate 22. For example, a cross section of the augment portion 40 canhave a substantially wedge-shaped geometry and may extend across a fullwidth of the main body portion 38 (e.g., “full-wedge”), as illustratedby FIGS. 1 and 5-6. The augment portion 40 can have other shaped orprofiles, such as a generally step-shaped geometry.

The augment portion 40 extends outwardly from the main body portion 38to establish an augment face section 42 of the rear face 30. The augmentface section 42 can be substantially planar. The augment face section 42can be generally concave or convex. The augment face section 42 cansubstantially slope or extend across the full width of the main bodyportion 38, with the augment face section 42 arranged transverselyrelative to the longitudinal axis A, as illustrated in FIGS. 2 and 4.The augment portion 40 can be dimensioned such that innermost (e.g.,lowest) and outermost (e.g., highest) points of the augment face section42 relative to the longitudinal axis A are defined along a perimeter ofthe augment portion 40.

The augment face section 42 can be arranged at various angles relativeto the main body portion 38 to establish a relative lesser or greateroverall volume of the baseplate 22. The augment face section 42 mayestablish an acute angle α relative to a reference plane that isperpendicular to the longitudinal axis A, as illustrated by FIG. 5. Theangle α may be greater than 0 degrees but may be less than 45 degrees.The angle α can be equal to or greater than approximately 5 degrees andless than or equal to approximately 45 degrees, for example. The angle αmay be approximately 10 or 20 degrees. For the purposes of thisdisclosure, the term “approximately” means ±5 percent of the statedvalue unless otherwise disclosed.

The baseplate 22 may include a plurality of peripheral apertures (orholes) 44 along the front face 28 of the plate body 26. The peripheralapertures 44 may extend between the front face 28 and rear face 30 ofthe plate body 26, with at least some or each of the peripheralapertures 44 extending through a thickness of the augment portion 40between the front face 28 and the augment face section 42 of the rearface 30, as illustrated in FIG. 5. Each peripheral aperture 44 can bedimensioned to receive a respective peripheral fastener PF (shown indashed lines in FIG. 3 for illustrative purposes) for securing thebaseplate 22 to a surgical site. Example fasteners may includecompression screws, as illustrated by the peripheral fasteners PF ofFIGS. 24A-25E.

The baseplate 22 can include one or more recesses 50 extending inwardlyfrom the front face 28 of the plate body 26. The recesses 50 can bedimensioned to receive an inserter or tooling T to insert or otherwiseposition the baseplate 22 along a surgical site (shown in dashed linesin FIG. 6 for illustrative purposes). The recesses 50 may be omitted.

The glenosphere 24 includes an articulating surface 25 which may have agenerally convex geometry, as illustrated by FIGS. 2 and 5. Thearticulating surface 25 may cooperate with a humeral component having agenerally concave, complementary geometry. The front face 28 can have agenerally concave geometry, as illustrated in FIGS. 5-6. The glenosphere24 may be omitted and the front face 28 may serve as an articulatingsurface that cooperates with a humeral component having a generallyconvex, complementary geometry.

The glenosphere 24 can be mechanically attached or releasably secured tothe baseplate 22 adjacent to the front face 28, as illustrated by FIGS.1 and 5. In FIG. 5, the glenosphere 24 may include a recess 27dimensioned to at least partially receive the main body portion 38 ofthe baseplate 22 adjacent to the front face 28. The recess 27 may bedimensioned to encircle a rim of the baseplate 22 along the front face28. A perimeter of the main body portion 38 of the baseplate 22 can bedimensioned to cooperate with a perimeter of the recess 27 to establisha Morse taper connection to secure the glenosphere 24 to the baseplate22. The plate body 26 can include a central aperture 43 extending alongthe longitudinal axis A. The glenosphere 24 can include an aperture 29dimensioned to receive a fastener F (shown in dashed lines in FIG. 5 forillustrative purposes). The fastener F can include threading thatcooperates with threading along the central aperture 43. The fastener Fcan serve to align the glenosphere 24 relative to the longitudinal axisA and/or secure the glenosphere 24 to the baseplate 24. The fastener Fand/or apertures 29, 43 and may be omitted. The anchoring stem 32 may beomitted and the aperture 43 may be dimensioned to receive a fastenersuch as a compression screw for securing the baseplate 24 to a surgicalsite (illustrated by fastener F′ of FIG. 7 in dashed lines in forillustrative purposes).

Referring to FIG. 3, with continuing reference to FIGS. 1-2, theperipheral apertures 44 can be circumferentially distributed about thelongitudinal axis A to establish a respective pattern (or layout) 48.Each pattern 48 can be predefined with respect to a geometry of thebaseplate 22 and augment portion 40. A perimeter of the augment portion40 is shown in dashed lines for illustrative purposes. The pattern 48can be defined with respect to the front face 28 of the plate body 26.The peripheral apertures 44 may be arranged relative to first and secondreference planes R1, R2 to establish the pattern 48. The first andsecond reference planes R1, R2 may be arranged perpendicular to eachother and can extend along the longitudinal axis A such that the firstreference plane R1 may bisect the augment face section 42 of the augmentportion 40. The augment portion 40 can be dimensioned such that theinnermost (e.g., lowest) and outermost (e.g., highest) points of theaugment face section 42 relative to the longitudinal axis A are definedalong the first reference plane R1.

FIG. 4 illustrates a perspective view of the baseplate 22 relative tothe reference plane R1. FIG. 5 illustrates a sectional view of thebaseplate 22 taken along the first reference plane R1 and through amaximum thickness of the augment portion 40. FIG. 6 illustrates asectional view of the baseplate 22 taken along the second referenceplane R2. The first and second reference planes R1, R2 may divide thebaseplate 22 into four quadrants I-VI. The baseplate 22 may besymmetrical on opposed sides of the first reference plane R1. Thebaseplate 22 may be asymmetrical on opposed sides of the first referenceplane R1.

The pattern 48 may be defined such that one or more of the peripheralapertures 44 extend along the first reference plane R1. In FIG. 3, thepattern 48 may be established by a total of four peripheral apertures44. The four peripheral apertures 44 can be spaced at approximately 90degree increments about the longitudinal axis A such that the apertures44 are substantially equally distributed about the longitudinal axis A.Two of the peripheral apertures 44 may extend along and be aligned withthe first reference plane R1 (indicated at 44-1, 44-3), and another twoof the peripheral apertures 44 may extend along and be aligned with thesecond reference plane R2 (indicated at 44-2, 44-4). The pattern 48 maybe defined such that the baseplate 22 is free of any peripheralapertures between adjacent pairs of the peripheral apertures 44.

Other example patterns can be utilized with any of the baseplatesdisclosed herein, and fewer or more than four peripheral apertures canbe utilized. One or more of the peripheral apertures 44-1 to 44-4 can beomitted. For example, apertures 44-2, 44-4 can be omitted such that thepattern 48 is established by the pair of opposed apertures 44-1, 44-3,or vice versa. In FIG. 7, pattern 48′ includes a total of threeperipheral apertures 44′ (indicated at 44-1′/44-3′, 44-5′ and 44-6′).Aperture 44-1′/44-3′ may extend along the first reference plane R1′.Apertures 44-5′, 44′6 may be circumferentially offset or otherwisespaced apart from both the first reference plane R1′ and secondreference plane R2′.

Referring to FIG. 5, with continuing reference to FIGS. 2-4, eachperipheral aperture 44 may extend along a respective passage axis PA.The passage axis PA can be parallel to the longitudinal axis A. In FIG.5, the passage axis PA is substantially transverse to the longitudinalaxis A, which can increase a spacing between terminal ends of adjacentfasteners inserted through the peripheral apertures 44. At least some ofthe peripheral apertures 44 can intersect a respective notch 45 alongthe perimeter 39 of the plate body 26.

Various patterns or layouts of peripheral apertures can be establishedto approximate a variety of different surface profiles and voidgeometries that may be encountered by the surgeon in preparation ofsurgery. The surgeon can be provided with a set of orthopedic implantsin a kit for arthroplasty, including any of the implants and patternsdisclosed herein. The kit can include a set of baseplates having any ofthe baseplates, augment geometries and patterns of the peripheralapertures disclosed herein. The kit can also include fasteners that arereceived in respective peripheral apertures to secure the respectivebaseplate to the surgical site.

FIGS. 8-13 illustrate an exemplary orthopedic implant 120. Referring toFIG. 8, the implant 120 may include a baseplate 122 having a plate body126 extending along a longitudinal axis A between a front (or first)face 128 and a rear (or second) face 130 generally opposed to the frontface 128. The baseplate 122 can include a central post or anchoring stem132 which may extend outwardly from the rear face 130 along alongitudinal axis A. The plate body 126 may include a main body portion138 and an augment portion 140 may extend outwardly from the main bodyportion 138. The main body portion 138 may establish a front face 128 ofthe plate body 126. The augment portion 140 may establish at least aportion of the rear face 130 and can have a substantially wedge-shapedgeometry.

The baseplate 122 may include a plurality of peripheral apertures (orholes) 144 along the front face 128 of the plate body 126 for securingthe baseplate 122 to a surgical site. The peripheral apertures 144 mayextend between the front face 128 and rear face 130, with at least someor each of the peripheral apertures 144 extending through a thickness ofthe augment portion 140 between the front face 128 and an augment facesection 142 of the rear face 130, as illustrated in FIG. 13. Eachperipheral aperture 144 can be dimensioned to receive a respectivefastener for securing the baseplate 122 to a surgical site.

Referring to FIG. 9, with continuing reference to FIG. 8, the peripheralapertures 144 can be circumferentially distributed about thelongitudinal axis A to establish a respective pattern (or layout) 148.The peripheral apertures 144 may be arranged relative to first andsecond reference planes R1, R2 such that the pattern 148 differs fromthe pattern 48 of peripheral apertures 44 (FIG. 3). The first referenceplane R1 may bisect an augment face section 142 of augment portion 140(shown in dashed lines for illustrated purposes). At least some of theperipheral apertures 144 may be circumferentially offset (e.g.,“obliquely” arranged) or are otherwise spaced apart from both of thefirst and second reference planes R1, R2 with respect to thelongitudinal axis A. In FIG. 9, all peripheral apertures 144 of thebaseplate 122 that are arranged about the longitudinal axis A may becircumferentially offset from both of the first and second referenceplanes R1, R2 with respect to the longitudinal axis A.

Various quantities of peripheral apertures 144 can be utilized toestablish the pattern 148. In FIG. 9, the baseplate 122 may include atotal of four peripheral apertures 144 (indicated at 144-1 to 144-4).However, it should be appreciated that fewer or more than fourperipheral apertures 144 can be utilized in accordance with theteachings disclosed herein. The peripheral apertures 144 aresubstantially uniformly distributed about the longitudinal axis A. Theperipheral apertures 144 may be non-uniformly distributed about thelongitudinal axis A such that some adjacent pairs of apertures 144 arerelatively closer or further away than other adjacent pairs of apertures144.

The baseplates 22, 122 can be provided as a set of baseplates (e.g.,first and second baseplates), with each baseplate 22, 122 establishing arespective pattern 48, 148 (e.g., first and second patterns). Theperipheral apertures 44 of the pattern 48 and the peripheral apertures144 of the pattern 148 can have a common number of peripheral apertures44/144 and can have a common circumferential spacing between respectiveadjacent apertures 44/144 relative to the longitudinal axis A. Thebaseplate 122 can have the same external profile or shape as thebaseplate 22.

The peripheral apertures 144 can be arranged such that the pattern 148is circumferentially offset from the pattern 48 (FIG. 3) relative to thelongitudinal axis A. For example, the baseplate 122 can be free of anyperipheral apertures 144 along the first reference plane R1 asillustrated by FIGS. 9-11. FIGS. 10-11 illustrate a sectional view ofthe baseplate 122 taken along the first reference plane R1 and through amaximum thickness of the augment portion 140. The peripheral apertures44, 144 of both patterns 48, 148 can be substantially equallydistributed about the longitudinal axis A.

In FIG. 9, a third reference plane R3 may extend along the longitudinalaxis A such that the first and third reference planes R1, R3 establishan acute angle β. A fourth reference plane R4 may extend along thelongitudinal axis A such that the second and fourth reference planes R2,R4 establish an acute angle φ. The third reference plane R3 may beperpendicular to the fourth reference plane R4. One or more of theapertures 144 may be circumferentially arranged along the thirdreference plane R3, and one or more of the apertures 144 may becircumferentially arranged along the fourth reference plane R4. Anopposed pair of the apertures 144-1, 144-3 may be arranged along thethird reference plane R3 (see also FIGS. 12-13), and another opposedpair of the apertures 144-2, 144-4 may be arranged along the fourthreference plane R4, as illustrated in FIG. 9. The angle β and/or angle φmay be greater than 0 degrees, such as between approximately 25 degreesand approximately 75 degrees, or more narrowly between approximately 30degrees and approximately 60 degrees such as approximately 45 degrees.The angle β and/or angle φ may be greater than 0 degrees but may be lessthan 45 degrees. The angle β and angle φ can be the same or can differ.The angle β and angle φ may be equal, and the pattern 148 of apertures144 may be circumferentially offset or shifted from the pattern 48 ofapertures 44 by the angle β relative to the longitudinal axis A.

In the embodiment of FIG. 14, pattern 148′ may circumferentially offsetor shifted from pattern 48 (FIG. 3) in a counterclockwise directionrelative to longitudinal axis A′. The apertures 144′ of the pattern 148′can be circumferentially offset to a lesser amount than the apertures144 of the pattern 148. Angle β′ and angle φ′ may be less than 45degrees, such as about 30 degrees. In FIG. 15, pattern 148″ may becircumferentially offset or shifted from pattern 48 in a clockwisedirection relative to longitudinal axis A″. Angle β″ and angle φ″ may beless than 45 degrees, such as about 30 degrees. The disclosed values ofangle β and/or angle φ can be positive (e.g., clockwise) or negative(e.g., counterclockwise) relative to the respective reference planes R1,R2.

Fewer or more than four circumferentially offset peripheral aperturescan be utilized. One or more of the peripheral apertures 144-1 to 144-4can be omitted. For example, apertures 144-2, 144-4 can be omitted suchthat the pattern 148 may be established by the pair of opposed apertures144-1, 144-3, or vice versa. As another example, apertures 144-1, 144-2can be omitted such that the pattern 148 is established by apertures144-3, 144-4, or vice versa.

FIGS. 16-19 illustrate an exemplary orthopedic implant 220. Referring toFIGS. 16-17, the implant 220 includes a baseplate 222 having a platebody 226 extending along a longitudinal axis A between a front (orfirst) face 228 and a rear (or second) face 230 which may generallyopposed to the front face 228. The baseplate 222 can include a centralpost or anchoring stem 232 which may extend outwardly from the rear face230 along a longitudinal axis A. The plate body 226 includes a main bodyportion 238 and an augment portion 240 which may extend outwardly fromthe main body portion 238. The main body portion 238 can establish afront face 228 of the plate body 226. The augment portion 240 canestablish at least a portion of the rear face 230 and can have asubstantially wedge-shaped geometry.

The augment portion 240 may be dimensioned to extend less than a fullwidth of the main body portion 238 (e.g., “partial-wedge”). The rearface 230 may include an augment face section 242 established by theaugment portion 240 and a second face section 247 joined at an interface246. The second face section 247 can be arranged along a reference planethat may be substantially perpendicular to the longitudinal axis A, asillustrated by FIG. 19. FIG. 19 illustrates a sectional view through amaximum thickness of the augment portion 240. The augment portion 240can be dimensioned to span approximately ½ of a width of the plate body226, with the interface 246 established along the longitudinal axis A(e.g., “half-wedge”), as illustrated by FIG. 16. The augment portion 240can be dimensioned to extend less than or greater than ½ of the width ofthe plate body 226, such as approximately ¾ of the width of the platebody 226 (e.g., “¾ wedge”).

The augment face section 142 may establish an acute angle α relative toa reference plane that may be perpendicular to the longitudinal axis A,as illustrated in FIG. 19. The angle α can be equal to or greater thanapproximately 5 degrees and more narrowly less than or equal toapproximately 45 degrees, for example. The angle α may be approximately15, 25 or 35 degrees. The geometry of the augment portion 240 can beutilized with any of the baseplates and/or patterns of peripheralapertures disclosed herein.

The baseplate 222 may include a plurality of peripheral apertures (orholes) 244 along the front face 228 of the plate body 226 for securingthe baseplate 222 to a surgical site, as illustrated in FIG. 17. Theperipheral apertures 244 can extend between the front face 228 and rearface 230 of the plate body 226, with at least some or each of theperipheral apertures 244 extending through a thickness of the augmentportion 240 between the front face 228 and an augment face section 242of the rear face 230, as illustrated in FIG. 18. In FIG. 18, only someof the peripheral apertures 244 may extend through the augment portion240, and at least one of the apertures 244 may extend between the frontface 288 and the second face section 247 of the rear face 230. Eachperipheral aperture 244 may be dimensioned to receive a respectivefastener for securing the baseplate 222 to a surgical site.

Referring to FIGS. 17-19, with continuing reference to FIG. 16, theperipheral apertures 244 can be circumferentially distributed about thelongitudinal axis A to establish a respective pattern (or layout) 248.The pattern 248 can be arranged according to any of the patternsdisclosed herein. The pattern 248 may correspond to the pattern 148 ofFIG. 9, with FIG. 18 being a sectional view taken along the third orfourth reference planes R3, R4, and FIG. 19 being a sectional view ofthe baseplate 222 of taken along the first reference plane R1.

FIG. 20 illustrates an exemplary pattern (or layout) 348. Baseplate 322includes an augment portion 340 (shown in dashed lines) that may extendless than a full width of the plate body 326. Peripheral apertures 344(indicated at 344-1 to 344-3) may be circumferentially distributed aboutlongitudinal axis A to establish the pattern 348. Each aperture 344 maybe circumferentially offset from an adjacent reference plane R1, R2 toestablish a respective angle β (indicated at β-1 to β-3). The angles β-1to β-3 can differ such that the apertures 344 are non-uniformlydistributed about the longitudinal axis A.

Other baseplate shapes or profiles can be utilized. In FIG. 20A, aperimeter 339′ of baseplate 322′ may have an elliptical, non-circulargeometry established by points P1′, P2′ along a major axis and pointsP3′, P4′ along a minor axis of the ellipse. The major and minor axes canbe aligned with first and second reference planes R1′, R2′, for example.In FIG. 20A, a perimeter 339″ of baseplate 322″ may have an ovoid-shapedgeometry established by points P1′, P2′ along a major axis and pointsP3′, P4′ along a minor axis of the ovoid. The major and minor axes canbe aligned with first and second reference planes R1″, R2″, for example.

FIG. 21 illustrates an exemplary method of installing an orthopaedicimplant at a surgical site in a flowchart 480. The method may beutilized to perform an arthroplasty for restoring functionality toshoulders having advanced cartilage disease, such as repairing bonedefects along a glenoid, for example. The method 480 can be utilizedwith any of the orthopedic implants, augment geometries and patterns ofperipheral apertures disclosed herein. Fewer or additional steps thanare recited below could be performed within the scope of thisdisclosure, and the recited order of steps is not intended to limit thisdisclosure.

A kit for arthroplasty can be provided at block 482. The kit can includeany of the components disclosed herein including a set of baseplates, aplurality of peripheral fasteners, and one or more glenospheres. At step484, a baseplate may be selected from a set of baseplates based on asurface profile of the surgical site. An exemplary surface profile of asurgical site S is illustrated by FIG. 22. Another exemplary surfaceprofile of a surgical site S′ is illustrated by FIG. 23. Other exemplarysurface profiles of surgical sites S are disclosed in FIGS. 24A-24E and25A-25E. The set of baseplates may include at least a first baseplate(e.g., baseplate 22) and a second baseplate (e.g., baseplate 122). Eachof the baseplates can include peripheral apertures arranged to establishthe respective pattern, including any of the patterns disclosed herein.The peripheral apertures of the second baseplate may be arranged toestablish a second pattern (e.g., pattern 148) which may becircumferentially offset from a first pattern (e.g., pattern 48) of thefirst baseplate relative to longitudinal axis. The first and secondpattern can have a common circumferential spacing between the respectiveperipheral apertures.

Referring to FIG. 22, with continuing reference to FIG. 21, the surgicalsite S can be prepared for receiving a prosthesis 410 including animplant 420 at step 486. The implant 420 can include a baseplate 422 andglenosphere 424. The implant 420 including the baseplate 422 maycorrespond to any of the implants and baseplates disclosed herein. Abackside of the baseplate 422 can include an augment portion 440 whichmay be dimensioned to abut a surface and/or fill a bone void along thesurgical site S. The augment portion 440 can have a generallywedge-shaped geometry.

One or more operations can be performed to prepare the surgical site S,such as one or more reaming, milling and drilling operations toestablish a desired geometry of the surgical site. Step 486 can includeforming a recess or bone hole BH at the surgical site S, such as anarticulating surface of a glenoid, by removing tissue such as bone B atthe surgical site S. A bone hole BH′ may be formed to remove tissue froma defect in bone B′ as illustrated by FIG. 23. The bone hole BH′ can bedimensioned to at least partially receive at least an augment portion440′ of baseplate 422′. A defect in the glenoid can be characterized bythe Walch Classification. The surgeon can measure bone loss utilizingimaging of the surgical site, such a radiogram or computed tomographytechnique, or can approximate a profile of the defect utilizing one ormore sizers and/or measuring devices placed against the bone surface.The bone hole BH′ can be dimensioned to approximate a profile of thedefect. A baseplate 422″ can be dimensioned such that an augment portion440″ may extend less than a full width of the baseplate 422″ (shown indashed lines in FIG. 23 for illustrative purposes).

At step 488, the selected baseplate 422 may be positioned relative tothe surface profile and bone hole BH of the surgical site S. Step 488can include positioning an anchoring stem 432 of the selected baseplate422 in the bone hole BH to secure the baseplate 422 at the surgical siteS.

At step 490, one or more fasteners may be positioned in a respective oneof the peripheral apertures along respective passage axes PA (shown indashed lines in FIG. 22 for illustrative purposes) to secure theselected baseplate to the surgical site S, as illustrated by theperipheral fasteners PF and peripheral apertures 44, 144 of thebaseplates 22, 122 of FIGS. 24A-24E and 25A-25E. In FIGS. 24A-24E and25A-25E, the peripheral fasteners PF may be compression screws that canserve to apply and maintain compression between the respective baseplate22, 122 and glenoid surface which may reduce relative motion and mayreduce tissue formation that may otherwise occur due to spacing betweenthe contact surfaces of the baseplate and glenoid.

At step 492, a head portion or glenosphere 424 can be secured to theselected baseplate 422 which may provide an articulating surface formating with an opposed articulating member M. The articulating member Mcan be an implant secured to a humerus, for example. The baseplate 422may provide the articulating surface.

FIGS. 24A-24E illustrate the implant 20 situated relative to a surgicalsite S at different view angles. FIGS. 25A-25E illustrate the implant120 situated relative to a surgical site S at different view angles.FIGS. 25A-25E can correspond to the same view angles of FIGS. 24A-24E,respectively. The geometry of the surgical sites S of FIGS. 24A-24E and25A-25E may be the same or may differ. The implants 20, 120 of FIGS.24A-24E and 25A-25E can be installed relative to the respective surgicalsite S utilizing the method 480 of FIG. 21, for example.

Each peripheral aperture 44, 144 may be dimensioned to receive arespective peripheral fastener PF to secure the plate body 26, 126 tothe surgical site S. The peripheral fasteners PF may extend at leastpartially through a thickness of the bone tissue at the surgical site S.

In FIG. 24A, the baseplate 22 can be arranged such that the first andsecond reference planes R1, R2 may be substantially aligned with theSuperior/Inferior (S/I) and/or Anterior/Posterior (A/P) planes of thepatient. One or more of the peripheral apertures 44 and peripheralfasteners PF may be positioned along the S/I plane and/or A/P plane.

In FIG. 25A, the first reference plane R1 of the baseplate 122 may bearranged such that the first and second reference planes R1, R2 may besubstantially aligned with the S/I and A/P planes. All of the peripheralapertures 144 can be circumferentially offset from the first referenceplane R1, second reference plane R2, S/I plane, and/or A/P plane.

FIGS. 26-27 illustrate an exemplary orthopaedic implant 520. The implant520 includes a baseplate 522 which may include a plate body 526 and anaugment portion 540 positioned relative to a main body portion 538. Themain body portion 538 and augment portion 540 may be separate anddistinct components. The baseplate 522 may include a plurality ofperipheral apertures 544 that may establish a pattern or layout 548. Theapertures 544 can be arranged according to any of the patterns disclosedherein.

The augment portion 540 may include one or more channels 550 extendingalong a respective path 552. The channels 550 may be elongated slots andmay be generally arcuate-shaped, as illustrated by FIGS. 26-27. Apassage axis PA of a respective aperture 544 can be substantiallyaligned with the path 522 of a respective channel 550. A first referenceplane R1 may bisect the augment portion 540, and a second referenceplane R2 may be perpendicular to the first reference plane R2. Thebaseplate 522 can include a lock mechanism 554 which may be moveablebetween an unlocked mode and a locked mode. The lock mechanism 554 caninclude a retention pin that may selectively engage one or moredepressions along the main body portion 538, for example.

The augment portion 540 may be rotatable in a direction RD (FIG. 27)about a longitudinal axis A of the baseplate 522 in the unlocked mode.The lock mechanism 554 can be moved to the locked mode which may limitmovement of the augment portion 540 relative to the main body portion538. FIG. 26 illustrates the augment portion 540 in a first positionrelative to the longitudinal axis A and peripheral apertures 544. FIG.27 illustrates augment portion 540′ in a second, different positionrelative to longitudinal axis A′ and peripheral apertures 544′. Asillustrated in FIG. 27, augment portion 540′ may be positioned such thatfirst and second reference planes R1′, R2′ established by the augmentportion 540′ may differ from a position of the first and secondreference planes R1, R2 established by the augment portion 540 of FIG.26. The channels 550 may be dimensioned to receive a respective fastenerinserted through an adjacent peripheral aperture 544 at differentpositions relative to baseplate 522 such as different circumferentialpositions relative to the longitudinal axis A. The augment portion 540may be positioned relative to the peripheral apertures 544 which mayimprove contact between the augment portion 540 and surface contouralong a surgical site and may improve fixation of fasteners received inthe respective apertures 544.

The novel implants and methods of this disclosure may provideversatility in securing the implants with fasteners to bone at asurgical site. The disclosed implants and augment geometries can beutilized to closely approximate a dimension of a bone surface, such as abone void, which can lead to improved healing at the surgical site. Thedisclosed patterns of peripheral apertures can be utilized to improvefixation of the respective implant by selecting a pattern based on ageometry of the surgical site and bone thicknesses at the respectivepositions of the peripheral apertures. The disclosed baseplates can havea circular or non-circular geometry. The disclosed baseplates havingsubstantially circular geometry may be utilized to orient the augmentportion of the baseplate in a multitude of directions to establish a“best fit” for the augment portion, while ensuring that the peripheralscrews may be in an optimal position. Additionally, having multipleorientations of the augment portion may help preserve glenoid boneduring the preparation for the baseplate.

Although the different non-limiting embodiments are illustrated ashaving specific components or steps, the embodiments of this disclosureare not limited to those particular combinations. It is possible to usesome of the components or features from any of the non-limitingembodiments in combination with features or components from any of theother non-limiting embodiments.

It should be understood that like reference numerals identifycorresponding or similar elements throughout the several drawings. Itshould further be understood that although a particular componentarrangement is disclosed and illustrated in these exemplary embodiments,other arrangements could also benefit from the teachings of thisdisclosure.

The foregoing description shall be interpreted as illustrative and notin any limiting sense. A worker of ordinary skill in the art wouldunderstand that certain modifications could come within the scope ofthis disclosure.

1-19. (canceled)
 20. A method of installing an orthopaedic implant at asurgical site comprising: selecting a baseplate from a set of baseplatesbased on a surface profile of a surgical site; wherein each baseplate ofthe set of baseplates includes a plate body having a main body portionand a substantially wedge-shaped augment portion that cooperate toestablish a front face and a rear face of the plate body, and aplurality of peripheral apertures extending between the front and rearfaces, and wherein a first reference plane extends along a longitudinalaxis of the plate body to bisect the augment portion; wherein the set ofbaseplates includes a first baseplate and a second baseplate, theperipheral apertures of the first baseplate are arranged to establish afirst pattern such that one or more of the peripheral apertures extendalong the first reference plane, and the peripheral apertures of thesecond baseplate are arranged to establish a second patterncircumferentially offset from the first pattern relative to thelongitudinal axis, and the first and second patterns have a commoncircumferential spacing between the respective peripheral apertures;positioning the selected baseplate relative to the surface profile ofthe surgical site; and positioning a fastener in a respective one of theperipheral apertures to secure the selected baseplate to the surgicalsite.
 21. The method as recited in claim 20, wherein: the plurality ofperipheral apertures include a total of four peripheral apertures; asecond reference plane extends along the longitudinal axis and isperpendicular to the first reference plane; two of the peripheralapertures of the first pattern are arranged along the first referenceplane, and another two of the peripheral apertures of the first patternare arranged along the second reference plane; the second pattern isestablished such that all peripheral apertures of the second baseplateare circumferentially offset from both the first and second referenceplanes.
 22. The method as recited in claim 20, wherein an anchoring stemextends outwardly from the rear face along the longitudinal axis, andfurther comprising: positioning the anchoring stem in a bone hole alongthe surgical site; and securing a glenosphere to the selected baseplate,the glenosphere including an articulating surface having a generallyconvex geometry.
 23. The method as recited in claim 20, wherein ananchoring stem extends outwardly from the rear face of the plate body.24. The method as recited in claim 23, wherein the anchoring stemextends along the longitudinal axis.
 25. The method as recited in claim20, wherein a perimeter of the plate body is substantially circular. 26.The method as recited in claim 20, wherein the plurality of peripheralapertures are substantially equally distributed about the longitudinalaxis.
 27. The method as recited in claim 26, wherein the plurality ofperipheral apertures include a total of four peripheral apertures. 28.The method as recited in claim 20, wherein a third reference planeextends along the longitudinal axis such that the first and thirdreference planes establish an acute angle, a pair of the peripheralapertures are circumferentially arranged along the third referenceplane, and the acute angle is between 30 degrees and 60 degrees.
 29. Themethod as recited in claim 28, wherein the plurality of peripheralapertures include a total of four peripheral apertures.
 30. The methodas recited in claim 29, wherein the four peripheral apertures aresubstantially uniformly distributed about the longitudinal axis.
 31. Themethod as recited in claim 30, wherein the acute angle is approximately45 degrees.
 32. The method as recited in claim 20, wherein the platebody is releasably securable to a glenosphere, and the glenosphereincludes an articulating surface having a generally convex geometry. 33.The method as recited in claim 32, wherein the glenosphere includes arecess dimensioned to at least partially receive the main body portionof the plate body.
 34. The method as recited in claim 33, wherein aperimeter of the main body portion of the plate body is dimensioned tocooperate with a perimeter of the recess to establish a Morse taperconnection.
 35. The method as recited in claim 20, wherein a secondreference plane extends along the longitudinal axis and is perpendicularto the first reference plane, and the second pattern is established suchthat all peripheral apertures of the second baseplate that are arrangedabout the longitudinal axis are circumferentially offset from the firstreference plane and from the second reference plane.
 36. The method asrecited in claim 35, wherein a perimeter of the plate body issubstantially circular.
 37. The method as recited in claim 36, whereinthe plurality of peripheral apertures are substantially equallydistributed about the longitudinal axis.
 38. The method as recited inclaim 20, wherein the step of positioning the selected baseplaterelative to the surface profile of the surgical site includes arrangingthe selected baseplate such that the first reference plane issubstantially aligned with a Superior/Inferior plane of a patient. 39.The method as recited in claim 38, wherein the selected baseplate is thesecond baseplate.
 40. The method as recited in claim 39, wherein aperimeter of the plate body is substantially circular.
 41. The method asrecited in claim 40, wherein: an anchoring stem extends along thelongitudinal axis and outwardly from the rear face of the plate body; asecond reference plane extends along the longitudinal axis and isperpendicular to the first reference plane; the plurality of peripheralapertures are substantially equally distributed about the longitudinalaxis; and the second pattern is established such that all peripheralapertures of the second baseplate that are arranged about thelongitudinal axis are circumferentially offset from the first referenceplane and from the second reference plane.